Conference abstract
Multidrug-resistant and extended-spectrum β-Lactamase (ESBL) - producing Enterobacterales isolated from carriage samples among HIV-infected women in Yaoundé, Cameroon
Pan African Medical Journal - Conference Proceedings. 2023:18(104).03
Oct 2023.
doi: 10.11604/pamj-cp.2023.18.104.2211
Archived on: 03 Oct 2023
Contact the corresponding author
Keywords: AMR, enterobacterales, HIV, MDR, Cameroon
Oral presentation
Multidrug-resistant and extended-spectrum β-Lactamase (ESBL) - producing Enterobacterales isolated from carriage samples among HIV-infected women in Yaoundé, Cameroon
Zemtsa Makala Ravalona Jessica1,&, Michel Noubom2, Luria Leslie Founou1, Brice Davy Dimani1, Patrice Landry Koudoum1, Aurelia Djeumako Mbossi1, Charles Kouanfack3, Raspail Carrel Founou1
1Research Institute of Centre of Expertise and Biological Diagnostic of Cameroon (CEDBCAM-RI), Yaounde, Cameroon, 2Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon, 3Central Hospital of Yaoundé, Yaoundé, Cameroon
&Corresponding author
Introduction: the exacerbation of antimicrobial resistance (AMR) is a worldwide public health threat. In Africa, data are scarce regarding multidrug-resistant as well as extended-spectrum β-lactamase producing Enterobacterales (ESBL-PE), isolated among clinical and asymptomatically healthy patients, especially in women living with HIV (WLHIV) despite their immunocompromised status. This study aimed to characterize genotypically multi-drug resistant Enterobacterales isolated from vaginal swabs of WLHIV attending the Yaoundé Central Hospital.
Methods: a cross-sectional study was conducted among WLHIV for four months, from 1 February to 31 May 2021. A total of 120 WLHIV, of childbearing age and under antiretroviral treatment were recruited and vaginal swabs were collected from them. After culturing on Eosine-Methylen Blue (EMB) agar, Enterobacterales were identified using the API 20E kit. A double-screening of ESBL-PE was performed using a combined disc diffusion method and ROSCO Diagnostica kits. An antibiotic susceptibility test was carried out by disc diffusion and the β-lactamase resistance genes, blaCTX-M, blaCTX-M-group1-2-9, and blaTEM were molecularly characterized using a conventional Polymerase Chain Reaction (PCR).
Results: Overall, 30.83% (37/120) of the included WLHIV were colonized with Enterobacterales, and the prevalence of vaginal carriage of MDR Enterobacterales among them was 62.16% (23/37). Among MDR-E isolates, the most prevalent species were E. coli (56.0%; 14/25) and K. pneumoniae (20.0%; 5/25). High rates of resistance to trimethoprim-sulfamethoxazole (96.0%; 24/25), amoxicillin-clavulanic acid (88.0%;22/25) and gentamicin (72%; 18/25) were observed. The resistance mechanisms detected among these isolates were ESBL (48.0%; 12/25), ESBL+ porin loss (8.0%; 2/25), ESBL+AmpC (24%; 6/25), with blaCTX-M, blaCTX-M-group-1,2,9 being identified at 48.0% (12/25) for each of them and blaTEM at 72.0% (18/25).
Conclusion: Our findings confirm the high prevalence of MDR as well as ESBL-PE isolated in WLHIV, and suggest that a real-time monitoring system of antimicrobial-resistant bacteria coupled with the reinforcement of infection prevention control (IPC) strategies is needed to sustainably contain these life-threatening pathogens, especially in the most vulnerable populations.
Multidrug-resistant and extended-spectrum β-Lactamase (ESBL) - producing Enterobacterales isolated from carriage samples among HIV-infected women in Yaoundé, Cameroon
Zemtsa Makala Ravalona Jessica1,&, Michel Noubom2, Luria Leslie Founou1, Brice Davy Dimani1, Patrice Landry Koudoum1, Aurelia Djeumako Mbossi1, Charles Kouanfack3, Raspail Carrel Founou1
1Research Institute of Centre of Expertise and Biological Diagnostic of Cameroon (CEDBCAM-RI), Yaounde, Cameroon, 2Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon, 3Central Hospital of Yaoundé, Yaoundé, Cameroon
&Corresponding author
Introduction: the exacerbation of antimicrobial resistance (AMR) is a worldwide public health threat. In Africa, data are scarce regarding multidrug-resistant as well as extended-spectrum β-lactamase producing Enterobacterales (ESBL-PE), isolated among clinical and asymptomatically healthy patients, especially in women living with HIV (WLHIV) despite their immunocompromised status. This study aimed to characterize genotypically multi-drug resistant Enterobacterales isolated from vaginal swabs of WLHIV attending the Yaoundé Central Hospital.
Methods: a cross-sectional study was conducted among WLHIV for four months, from 1 February to 31 May 2021. A total of 120 WLHIV, of childbearing age and under antiretroviral treatment were recruited and vaginal swabs were collected from them. After culturing on Eosine-Methylen Blue (EMB) agar, Enterobacterales were identified using the API 20E kit. A double-screening of ESBL-PE was performed using a combined disc diffusion method and ROSCO Diagnostica kits. An antibiotic susceptibility test was carried out by disc diffusion and the β-lactamase resistance genes, blaCTX-M, blaCTX-M-group1-2-9, and blaTEM were molecularly characterized using a conventional Polymerase Chain Reaction (PCR).
Results: Overall, 30.83% (37/120) of the included WLHIV were colonized with Enterobacterales, and the prevalence of vaginal carriage of MDR Enterobacterales among them was 62.16% (23/37). Among MDR-E isolates, the most prevalent species were E. coli (56.0%; 14/25) and K. pneumoniae (20.0%; 5/25). High rates of resistance to trimethoprim-sulfamethoxazole (96.0%; 24/25), amoxicillin-clavulanic acid (88.0%;22/25) and gentamicin (72%; 18/25) were observed. The resistance mechanisms detected among these isolates were ESBL (48.0%; 12/25), ESBL+ porin loss (8.0%; 2/25), ESBL+AmpC (24%; 6/25), with blaCTX-M, blaCTX-M-group-1,2,9 being identified at 48.0% (12/25) for each of them and blaTEM at 72.0% (18/25).
Conclusion: Our findings confirm the high prevalence of MDR as well as ESBL-PE isolated in WLHIV, and suggest that a real-time monitoring system of antimicrobial-resistant bacteria coupled with the reinforcement of infection prevention control (IPC) strategies is needed to sustainably contain these life-threatening pathogens, especially in the most vulnerable populations.
